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Hsu SH, Wong YK, Wang CP, Wang CC, Jiang RS, Chen FJ, Liu SA. Survival analysis of patients with oral squamous cell carcinoma with simultaneous second primary tumors. Head Neck 2013; 35:1801-7. [PMID: 23483643 DOI: 10.1002/hed.23242] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/06/2012] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND The purpose of this study was to investigate the rate of simultaneous second primary tumor (SPT) in patients with oral squamous cell carcinoma. The survival of patients with simultaneous SPT was also compared with patients without. METHODS The presence of SPT was documented along with the patients' demographic data, tumor-related features, and survival status. Kaplan-Meier method was used for survival analysis. Relevant factors influencing the survival were examined by the Cox proportional hazard model. RESULTS A total of 897 patients' medical records were obtained. Among them, 43 patients (4.8%) had simultaneous SPT and their prognosis was poorer than that of patients without. The Cox proportional hazard model revealed that patients with simultaneous SPT tended to have a higher probability of death (relative risk [RR], 1.694; p = .015). CONCLUSIONS Simultaneous SPT is an independent prognostic factor for patients with oral squamous cell carcinoma. Those with simultaneous SPT have poorer survival when compared to those without.
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Affiliation(s)
- Shuo-Hsiu Hsu
- Department of Otolaryngology, Taichung Veterans General Hospital, Taichung, Taiwan
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Senesse P, Vasson MP. Nutrition chez le patient adulte atteint de cancer : quand et comment évaluer l’état nutritionnel d’un malade atteint de cancer ? Comment faire le diagnostic de dénutrition et le diagnostic de dénutrition sévère chez un malade atteint de cancer ? Quelles sont les situations les plus à risque de dénutrition ? NUTR CLIN METAB 2012. [DOI: 10.1016/j.nupar.2012.10.004] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
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Chang PH, Wang CH, Huang JS, Lai CH, Wu TH, Lan YJ, Tsai JCS, Chen EYC, Yang SW, Yeh KY. Low body mass index at 3 months following adjuvant chemoradiation affects survival of postoperative locally advanced oral cavity cancer patients. Laryngoscope 2012; 122:2193-8. [DOI: 10.1002/lary.23450] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2012] [Revised: 04/24/2012] [Accepted: 04/30/2012] [Indexed: 11/11/2022]
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Wheler J, Tsimberidou AM, Hong D, Naing A, Falchook G, Piha-Paul S, Fu S, Moulder S, Stephen B, Wen S, Kurzrock R. Survival of 1,181 patients in a phase I clinic: the MD Anderson Clinical Center for targeted therapy experience. Clin Cancer Res 2012; 18:2922-9. [PMID: 22452943 DOI: 10.1158/1078-0432.ccr-11-2217] [Citation(s) in RCA: 78] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
PURPOSE To determine whether the Royal Marsden Hospital (RMH; London, UK) prognostic score for phase I patients can be validated in a large group of individuals seen in a different center and whether other prognostic variables are also relevant, we present an analysis of 1,181 patients treated in the MD Anderson Cancer Center (MDACC; Houston, TX) phase I clinic. EXPERIMENTAL DESIGN Medical records of 1,181 consecutive patients who were treated on at least one trial in the phase I clinic were reviewed. RESULTS The median age was 58 years and 50% were women. The median number of prior therapies was four and median survival 10 months [95% confidence interval (CI), 9.1-10.9 months]. Independent factors that predicted shorter survival in a multivariate Cox model and could be internally validated included RMH score of >1 (P < 0.0001; albumin <3.5 g/dL; lactate dehydrogenase >upper limit of normal, and >two sites of metastases), gastrointestinal tumor type (P < 0.0001), and Eastern Cooperative Oncology Group performance status ≥ 1 (P = 0.0004). The median survival was 24.0, 15.2, 8.4, 6.2, and 4.1 months for patients with 0, 1, 2, 3, and 4 or 5 of the above risk factors, respectively. CONCLUSION The RMH score was validated in a large group of patients at MDACC. Internal validation of the independent prognostic factors for survival led to the development of the MDACC prognostic score, a modification of the RMH score that strengthens it.
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Affiliation(s)
- Jennifer Wheler
- Department of Investigational Cancer Therapeutics, Phase I Clinical Trials Program, Biostatistics, and Breast Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas 77030, USA.
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Maruyama T, Yamanaka R, Yokoi A, Ekuni D, Tomofuji T, Mizukawa N, Onoda T, Eguchi M, Morita M. Relationship between serum albumin concentration and periodontal condition in patients with head and neck cancer. J Periodontol 2011; 83:1110-5. [PMID: 22181688 DOI: 10.1902/jop.2011.110536] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND Serum albumin concentration is known to be an independent predictor of survival in head and neck cancer. The previous studies suggested relationships between serum albumin concentration and oral health status in populations without serious systemic disorders. However, these relationships remain unclear in patients with head and neck cancer. The purpose of this study is to investigate the relationship between serum albumin concentration and oral health status in patients with head and neck cancer. METHODS Fifty individuals diagnosed with primary head and neck cancer, 25 individuals with normal serum albumin concentration (≥3.85 g/dL), and 25 age- and sex-matched individuals with lower serum albumin concentration (<3.85 g/dL) were analyzed. General status, including cancer stage, body mass index, drinking and smoking habits, and biochemical serum markers, were evaluated. Oral health status, including periodontal condition and occlusion tooth pairs, were also evaluated. RESULTS Mean clinical attachment level (CAL) and C-reactive protein in the lower serum albumin concentration group were greater than those in the normal serum albumin concentration group (P = 0.009 and P = 0.002, respectively). However, there were no significant differences in any other oral and/or serum parameters between the two serum albumin groups. A logistic regression model showed that mean CAL was significantly associated with high or low levels of serum albumin concentration (odds ratio = 9.752; 95% confidence interval = 1.702 to 55.861; P = 0.011). CONCLUSIONS This study suggests an association between periodontal disease and serum albumin concentration in patients with head and neck cancer. Longitudinal studies are necessary to examine the causal relationship between serum albumin concentration and periodontal condition.
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Affiliation(s)
- Takayuki Maruyama
- Department of Preventive Dentistry, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama, Japan
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Somatic mutations in the D-loop of mitochondrial DNA in oral squamous cell carcinoma. Eur Arch Otorhinolaryngol 2011; 269:1665-70. [PMID: 22020698 DOI: 10.1007/s00405-011-1806-5] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2011] [Accepted: 10/06/2011] [Indexed: 10/16/2022]
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Hsing CY, Wong YK, Wang CP, Wang CC, Jiang RS, Chen FJ, Liu SA. Comparison between free flap and pectoralis major pedicled flap for reconstruction in oral cavity cancer patients – A quality of life analysis. Oral Oncol 2011; 47:522-7. [DOI: 10.1016/j.oraloncology.2011.03.024] [Citation(s) in RCA: 62] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2011] [Revised: 03/22/2011] [Accepted: 03/23/2011] [Indexed: 10/18/2022]
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Wang CH, Wang HM, Pang YP, Yeh KY. Early nutritional support in non-metastatic stage IV oral cavity cancer patients undergoing adjuvant concurrent chemoradiotherapy: analysis of treatment tolerance and outcome in an area endemic for betel quid chewing. Support Care Cancer 2011; 20:1169-74. [DOI: 10.1007/s00520-011-1192-y] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2010] [Accepted: 05/09/2011] [Indexed: 12/25/2022]
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Oh IS, Kim SI, Ha KY. Significant predictive values for the life expectancy in patients with spinal metastasis following surgical treatment. EUROPEAN JOURNAL OF ORTHOPAEDIC SURGERY AND TRAUMATOLOGY 2011. [DOI: 10.1007/s00590-011-0807-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
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Smoking, alcohol, and betel quid and oral cancer: a prospective cohort study. JOURNAL OF ONCOLOGY 2011; 2011:525976. [PMID: 21547265 PMCID: PMC3087410 DOI: 10.1155/2011/525976] [Citation(s) in RCA: 83] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/10/2010] [Accepted: 01/21/2011] [Indexed: 11/17/2022]
Abstract
We aimed to investigate the association between smoking, alcoholic consumption, and betel quid chewing with oral cancer in a prospective manner. All male patients age ≥18 years who visited our clinic received an oral mucosa inspection. Basic data including personal habits were also obtained. A multivariate logistic regression model was utilized to determine relevant risk factors for developing oral cavity cancer. A total of 10,657 participants were enrolled in this study. Abnormal findings were found in 514 participants (4.8%). Three hundred forty-four participants received biopsy, and 230 patients were proven to have oral cancer. The results of multivariate logistic regression found that those who smoked, consumed alcohol, and chewed betel quid on a regular basis were most likely to develop cancer (odds ratio: 46.87, 95% confidence interval: 31.84-69.00). Therefore, habitual cigarette smokers, alcohol consumers, and betel quid chewers have a higher risk of contracting oral cancer and should receive oral screening regularly so potential oral cancer can be detected as early as possible.
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Gupta D, Lis CG. Pretreatment serum albumin as a predictor of cancer survival: a systematic review of the epidemiological literature. Nutr J 2010; 9:69. [PMID: 21176210 PMCID: PMC3019132 DOI: 10.1186/1475-2891-9-69] [Citation(s) in RCA: 905] [Impact Index Per Article: 64.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2010] [Accepted: 12/22/2010] [Indexed: 12/11/2022] Open
Abstract
Background There are several methods of assessing nutritional status in cancer of which serum albumin is one of the most commonly used. In recent years, the role of malnutrition as a predictor of survival in cancer has received considerable attention. As a result, it is reasonable to investigate whether serum albumin has utility as a prognostic indicator of cancer survival in cancer. This review summarizes all available epidemiological literature on the association between pretreatment serum albumin levels and survival in different types of cancer. Methods A systematic search of the literature using the MEDLINE database (January 1995 through June 2010) to identify epidemiologic studies on the relationship between serum albumin and cancer survival. To be included in the review, a study must have: been published in English, reported on data collected in humans with any type of cancer, had serum albumin as one of the or only predicting factor, had survival as one of the outcome measures (primary or secondary) and had any of the following study designs (case-control, cohort, cross-sectional, case-series prospective, retrospective, nested case-control, ecologic, clinical trial, meta-analysis). Results Of the 29 studies reviewed on cancers of the gastrointestinal tract, all except three found higher serum albumin levels to be associated with better survival in multivariate analysis. Of the 10 studies reviewed on lung cancer, all excepting one found higher serum albumin levels to be associated with better survival. In 6 studies reviewed on female cancers and multiple cancers each, lower levels of serum albumin were associated with poor survival. Finally, in all 8 studies reviewed on patients with other cancer sites, lower levels of serum albumin were associated with poor survival. Conclusions Pretreatment serum albumin levels provide useful prognostic significance in cancer. Accordingly, serum albumin level could be used in clinical trials to better define the baseline risk in cancer patients. A critical gap for demonstrating causality, however, is the absence of clinical trials demonstrating that raising albumin levels by means of intravenous infusion or by hyperalimentation decreases the excess risk of mortality in cancer.
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Affiliation(s)
- Digant Gupta
- Cancer Treatment Centers of America® at Midwestern Regional Medical Center, Zion, IL, USA
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Yang WCV, Chung HR, Wu JY, Yi C, Wang DJ, Lee SY. Potential biomarkers for the cytologic diagnosis of oral squamous cell carcinoma. J Dent Sci 2010. [DOI: 10.1016/s1991-7902(10)60010-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
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Comparison of the effect of individual dietary counselling and of standard nutritional care on weight loss in patients with head and neck cancer undergoing radiotherapy. Br J Nutr 2010; 104:872-7. [DOI: 10.1017/s0007114510001315] [Citation(s) in RCA: 74] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Clinical research shows that nutritional intervention is necessary to prevent malnutrition in head and neck cancer patients undergoing radiotherapy. The objective of the present study was to assess the value of individually adjusted counselling by a dietitian compared to standard nutritional care (SC). A prospective study, conducted between 2005 and 2007, compared individual dietary counselling (IDC, optimal energy and protein requirement) to SC by an oncology nurse (standard nutritional counselling). Endpoints were weight loss, BMI and malnutrition (5 % weight loss/month) before, during and after the treatment. Thirty-eight patients were included evenly distributed over two groups. A significant decrease in weight loss was found 2 months after the treatment (P = 0·03) for IDC compared with SC. Malnutrition in patients with IDC decreased over time, while malnutrition increased in patients with SC (P = 0·02). Therefore, early and intensive individualised dietary counselling by a dietitian produces clinically relevant effects in terms of decreasing weight loss and malnutrition compared with SC in patients with head and neck cancer undergoing radiotherapy.
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Potential biomarkers in saliva for oral squamous cell carcinoma. Oral Oncol 2010; 46:226-31. [PMID: 20138569 DOI: 10.1016/j.oraloncology.2010.01.007] [Citation(s) in RCA: 125] [Impact Index Per Article: 8.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2009] [Revised: 01/08/2010] [Accepted: 01/11/2010] [Indexed: 12/24/2022]
Abstract
Sensitive and reliable early diagnostic markers for oral squamous cell carcinoma (OSCC) remain unavailable. Early identification of recurrence for OSCC is also a challenge. Unlike the other deep cancers, OSCC is located in oral cavity. The DNA, RNA, and protein derived from the living cancer cells and inflammatory cells then can be conveniently obtained from saliva. High-throughput genomic and proteomic approaches have been carried out to identify the potential biomarkers in body fluids such as saliva and blood for diagnosis and prognosis of OSCC. This article reviewed the recently identified biomarkers from saliva for OSCC. In addition, the biomarkers which have been correlated with OSCC tumor malignancy by molecular pathology analysis are also described. Finally, the potential biomarkers that have been demonstrated to associate with the malignant OSCC may be used for salivary screening for high-risk patients are suggested. This article may help to identify the potential biomarkers for screening and the molecular pathology analysis for high-risk patients of OSCC. Effective screening to identify high-risk patients can allow the clinician to provide the appropriate treatment without delay and to reduce the recurrence of OSCC.
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Penel N, Negrier S, Ray-Coquard I, Ferte C, Devos P, Hollebecque A, Sawyer MB, Adenis A, Seve P. Development and validation of a bedside score to predict early death in cancer of unknown primary patients. PLoS One 2009; 4:e6483. [PMID: 19649260 PMCID: PMC2715134 DOI: 10.1371/journal.pone.0006483] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2009] [Accepted: 06/17/2009] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND We have investigated predictors of 90-day-mortality in a large cohort of non-specific cancer of unknown primary patients. METHODS Predictors have been identified by univariate and then logistic regression analysis in a single-center cohort comprising 429 patients (development cohort). We identified four predictors that produced a predictive score that has been applied to an independent multi-institutional cohort of 409 patients (validation cohort). The score was the sum of predictors for each patient (0 to 4). RESULTS The 90-day-mortality-rate was 33 and 26% in both cohorts. Multivariate analysis has identified 4 predictors for 90-day-mortality: performance status>1 (OR = 3.03, p = 0.001), at least one co-morbidity requiring treatment (OR = 2.68, p = 0.004), LDH>1.5 x the upper limit of normal (OR = 2.88, p = 0.007) and low albumin or protein levels (OR = 3.05, p = 0.007). In the development cohort, 90-day-mortality-rates were 12.5%, 32% and 64% when the score was [0-1], 2 and [3]-[4], respectively. In the validation cohort, risks were 13%, 25% and 62% according to the same score values. CONCLUSIONS We have validated a score that is easily calculated at the beside that estimates the 90-days mortality rate in non-specific CUP patients. This could be helpful to identify patients who would be better served with palliative care rather than aggressive chemotherapy.
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Affiliation(s)
- Nicolas Penel
- Département de Cancérologie Générale, Centre Oscar Lambret, Lille, France.
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Lawson JD, Gaultney J, Saba N, Grist W, Davis L, Johnstone PA. Percutaneous feeding tubes in patients with head and neck cancer: rethinking prophylactic placement for patients undergoing chemoradiation. Am J Otolaryngol 2009; 30:244-9. [PMID: 19563935 DOI: 10.1016/j.amjoto.2008.06.010] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2008] [Revised: 05/08/2008] [Accepted: 06/05/2008] [Indexed: 10/21/2022]
Abstract
OBJECTIVES Although intensified therapy has contributed to improved outcomes for patients with head and neck cancer, acute toxicity has increased as well. To lessen the severity of nutritional compromise in these patients, our institutional protocol has been to routinely place feeding tubes before the initiation of therapy. This investigation details the toxicities associated with feeding tube placement and predictors for duration of tube dependence. MATERIALS AND METHODS The records of the Radiation Oncology Department at Emory Clinic were reviewed for patients receiving definitive radiotherapy between 6/1/2003 and 6/1/2006. The records of the subset of patients with feeding tube placement before the initiation of therapy were then reviewed for toxicities as well as length of time of tube dependence. RESULTS There were 102 eligible patients. Radiotherapy was delivered with concomitant chemotherapy in all. Median time with feeding tube in place for all patients was 4.4 months (range, 0.2-28.9 months). For 82 patients with eventual tube removal, the median time of tube dependence was 3.8 months (range, 1.4-28.9 months). Risk factors for prolonged tube dependence are analyzed; on multivariate analysis, patient age, T stage, and nodal status remained significant. The most common complication was tube replacement, with 11.8% of all tubes requiring replacement. Infection and pain occurred in 8.8% and 5.9% of patients, respectively. CONCLUSION Feeding tubes are required for more than 2 months after combined modality treatment of head and neck cancer. They are generally well tolerated, but toxicities are not trivial: more than 10% require replacement and more than 8% of patients develop infection at the insertion site. We are assessing their routine placement in light of these data.
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Penel N, Delord JP, Bonneterre ME, Bachelot T, Ray-Coquard I, Blay JY, Pascal LB, Borel C, Filleron T, Adenis A, Bonneterre J. Development and validation of a model that predicts early death among cancer patients participating in phase I clinical trials investigating cytotoxics. Invest New Drugs 2009; 28:76-82. [PMID: 19205623 DOI: 10.1007/s10637-009-9224-x] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2008] [Accepted: 01/27/2009] [Indexed: 12/11/2022]
Abstract
OBJECTIVE Selecting patients for phase 1 studies remains challenging. Given the lack of clear and reliable guidance for the estimation of life expectancy, we retrospectively assessed predictive factors of early death (within 90 days following inclusion) among these patients. METHODS Two hundred fifty-seven consecutive cancer patients enrolled in phase I studies investigating cytotoxics at Oscar Lambret Cancer Center and Institut Claudius Regaud were included in the development database. Univariate and multivariate analyses (logistic regression model) were undertaken to determine the prognostic factors. A probability tree described the rate of early death in the different prognostic subgroups. This prognostic model was then evaluated on a second independent cohort of 128 patients treated at Léon Bérard Cancer Center. RESULTS The median overall survival was 8.4 months in the dataset population, and the rate of early death was 15%. In multivariate analysis, the two prognostic factors for early death were albumin <38 g/l (OR = 5.21) and lymphocytes <700/mm(3) (OR = 3.88). According to these two parameters, three prognostic subgroups were defined with early death rates of, respectively, 8/121 (6%), 19/119 (16%) and 13/17 (76%). In the validation dataset, the rates of early death according to three prognostic groups were 13/68 (19%), 20/57 (35%) and 3/3 (100%), respectively. CONCLUSION We do not recommend the enrolment of patients with albumin level below 38g/l and lymphocytes count below 700/mm(3), in phase 1 trial investigating cytotoxics. Our model is helpful to discriminate "patients with reasonable life expectancy" as defined in most phase 1 protocols.
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Affiliation(s)
- Nicolas Penel
- Département de Cancérologie Générale, Centre Oscar Lambret, 3, Rue F Combemale, Lille, France.
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Liang MT, Chen CCC, Wang CP, Wang CC, Lin WD, Liu SA. The association of lymph node volume with cervical metastatic lesions in head and neck cancer patients. Eur Arch Otorhinolaryngol 2008; 266:883-7. [DOI: 10.1007/s00405-008-0818-2] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2008] [Accepted: 09/11/2008] [Indexed: 10/21/2022]
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The association of smoking, alcoholic consumption, betel quid chewing and oral cavity cancer: a cohort study. Eur Arch Otorhinolaryngol 2008; 265:1403-7. [DOI: 10.1007/s00405-008-0659-z] [Citation(s) in RCA: 50] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2007] [Accepted: 03/25/2008] [Indexed: 11/26/2022]
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Penel N, Vanseymortier M, Bonneterre ME, Clisant S, Dansin E, Vendel Y, Beuscart R, Bonneterre J. Prognostic factors among cancer patients with good performance status screened for phase I trials. Invest New Drugs 2007; 26:53-8. [PMID: 17891337 DOI: 10.1007/s10637-007-9088-x] [Citation(s) in RCA: 44] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2007] [Accepted: 09/04/2007] [Indexed: 11/26/2022]
Abstract
BACKGROUND Selecting patients for phase I trials in order to investigate cytotoxic agents is challenging, since there is no clear and reliable guidance to estimate life expectancy among these patients. We retrospectively assessed prognostic factors in cancer patients screened for Phase1 trials between October 1997 and October 2002. METHODS 148 consecutive patients, screened for inclusion in phase I trials investigating cytotoxic agents, were included in the present study. 70 out of them actually received phase I trial regimens. Univariate and multivariate analysis were undertaken to determine the prognostic factors for overall survival (OS) from the date of screening. RESULTS The median OS of the 148 patients was 5.7 months. Ninety-two percent of them had PS<or=1. The Cox model identified serum albumin<38 g/l [HR 2.51 (1.51-4.18), p=0.0001] and lymphocyte count<700/mm3 [HR 2.27 (1.13-4.62), p=0.024] as independent prognostic for overall survival. All patients presenting both prognostic factors died within 90 days. CONCLUSIONS We propose a simple model, easily obtained at the bedside, which can discriminate patients who are likely to be alive at 3 months and thus could be included in a phase 1 anti-cancer trial. This model now needs to be validated on an independent cohort.
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Affiliation(s)
- Nicolas Penel
- Département de Cancérologie Générale, Centre Oscar Lambret, Lille 3, rue F Combemale, 59020, Lille, France.
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Yang KY, Jiang RS, Shiao JY, Wang CC, Wang CP, Liang KL, Twu CW, Liu SA. Visual screening of oral cavity cancer: The role of otolaryngologists. Laryngoscope 2007; 117:92-5. [PMID: 17202936 DOI: 10.1097/01.mlg.0000245012.83011.50] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVES Because most screening was done by dentists, the purpose of this prospective cohort study was to evaluate the effectiveness of oral visual screening by otolaryngologists. In addition, we wanted to determine which group of enrolled patients was at potential risk of contracting oral cancer. METHODS All male patients age > or =18 years who visited our clinic received oral mucosal screening. Basic data, including personal habits, were also obtained. A multivariate logistic regression model was devised to determine relevant risk factors for developing oral cancer. RESULTS A total of 5,825 patients were enrolled in this study. Positive findings were found in 226 patients (3.9%). One hundred seventy-two patients received biopsy and 131 patients were proven to have oral cancer (sensitivity rate: 76.2%). The results showed that those who smoked, consumed alcohol, and chewed betel quid on a regular basis were most likely to contract oral cancer (odds ratio = 49.81, 95% confidence interval = 29.38-84.42). CONCLUSIONS The otolaryngologists involved in this study successfully performed the oral screening. The sensitivity and specificity rates were both satisfactory. We suggest that those who are habitual cigarette smokers, alcohol consumers, and betel quid chewers should receive oral mucosal screening regularly so that potential oral cancer can be detected as early as possible.
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Affiliation(s)
- Kung-Yaun Yang
- Department of Otolaryngology, Taichung Veterans General Hospital, Taichung, Taiwan
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